Kentucky Advance Directive Form (Medical POA + Living Will)

A Kentucky advance directive is a document that provides medical staff and the principal’s agent with medical directives for end-of-life wishes. The living will allows the patient to note specific medical wishes while choosing a healthcare surrogate lets a trusted agent make the principal’s medical decisions in the event that they become incapacitated and cannot do so themselves.

Laws

Statutory Form§ 311.625

Signing Requirements (§ 311.625(2)) – In the presence of two (2) witnesses or acknowledged before a notary public.

State Definition (§ 311.621(2)) – “Advance directive” means a living will directive made in accordance with KRS 311.621 to 311.643, a living will or designation of health care surrogate executed prior to July 15, 1994, and any other document that provides directions relative to health care to be provided to the person executing the document.

Spanish (Español) VersionAdobe PDF

Versions (4)


Cabinet for Health and Family Services

Download: Adobe PDF

 

 

 

 


Norton Healthcare

Download: Adobe PDF

 

 


Logan Memorial

Download: Adobe PDF

 

 

 

 


blankCatholic Conference of Kentucky

Download: Adobe PDF